Aortic Insufficiency During HeartMate 3 Left Ventricular Assist Device Support.
heart failure
hemodynamic
regurgitation
Journal
Journal of cardiac failure
ISSN: 1532-8414
Titre abrégé: J Card Fail
Pays: United States
ID NLM: 9442138
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
12
02
2020
revised:
16
05
2020
accepted:
18
05
2020
pubmed:
31
5
2020
medline:
19
8
2021
entrez:
31
5
2020
Statut:
ppublish
Résumé
Aortic insufficiency (AI) is associated with morbidity and mortality in patients with continuous-flow left ventricular assist devices (LVADs), whereas its impact on the HeartMate 3 LVAD cohorts remains uninvestigated. We aimed to investigate the clinical impact of AI on patients with HeartMate 3 LVADs. Consecutive 61 patients (median age 54 years; 67% male) implanted with HeartMate 3 LVAD between 2015 and 2019 were enrolled and underwent echocardiography at 3 months after LVAD implantation. AI severity was quantified by the novel Doppler echocardiographic method obtained at the outflow cannula and the calculated regurgitation fraction of 30% or greater (moderate or greater) was defined as significant. At 3 months after implant, 12 patients (20%) had significant AI. They had a higher incidence of death or heart failure readmissions compared with those without significant AI during a 1-year observational period (70% vs 24%, P = .003) with an adjusted hazard ratio of 2.76 (95% confidence interval 1.03-7.88). In patients with HeartMate 3 LVAD support, significant AI remains both prevalent and a clinically significant downstream complication.
Sections du résumé
BACKGROUND
BACKGROUND
Aortic insufficiency (AI) is associated with morbidity and mortality in patients with continuous-flow left ventricular assist devices (LVADs), whereas its impact on the HeartMate 3 LVAD cohorts remains uninvestigated. We aimed to investigate the clinical impact of AI on patients with HeartMate 3 LVADs.
METHODS AND RESULTS
RESULTS
Consecutive 61 patients (median age 54 years; 67% male) implanted with HeartMate 3 LVAD between 2015 and 2019 were enrolled and underwent echocardiography at 3 months after LVAD implantation. AI severity was quantified by the novel Doppler echocardiographic method obtained at the outflow cannula and the calculated regurgitation fraction of 30% or greater (moderate or greater) was defined as significant. At 3 months after implant, 12 patients (20%) had significant AI. They had a higher incidence of death or heart failure readmissions compared with those without significant AI during a 1-year observational period (70% vs 24%, P = .003) with an adjusted hazard ratio of 2.76 (95% confidence interval 1.03-7.88).
CONCLUSIONS
CONCLUSIONS
In patients with HeartMate 3 LVAD support, significant AI remains both prevalent and a clinically significant downstream complication.
Identifiants
pubmed: 32473380
pii: S1071-9164(20)30151-2
doi: 10.1016/j.cardfail.2020.05.013
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
863-869Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.